CMS increased 2026 RTM reimbursement for CPT codes 98985 and 98977. See what it means for your practice and how Circle Health can help.
If your organization has been on the fence about launching a Remote Therapeutic Monitoring (RTM) program, CMS just made the financial case significantly stronger.
In a move that surprised many industry observers, CMS updated the practice-expense portion of two key RTM CPT codes - 98985 (device supply, 2–15 days) and 98977 (device supply, 16–30 days) - resulting in reimbursement rates that are meaningfully higher than what the final rule had led providers to expect. For organizations planning to implement or scale RTM in 2026, this is a pivotal development.
What Changed and Why It Matters
CMS's update targets the practice-expense component of two foundational MSK RTM codes. The impact: reimbursement levels for both codes have climbed above what was projected, giving practices a stronger revenue floor for every enrolled RTM patient.
To understand the significance of this update, it helps to know how the 2026 RTM code family was already expanding. As we covered in our overview of RTM in Healthcare, CMS introduced two brand-new CPT codes effective January 1, 2026:
- 98985 - for patients with 2–15 days of data transmission (a newly eligible, shorter monitoring window)
- 98979 - for patients with 10–19 minutes of monthly treatment management services (a new lower-threshold tier)
The intent was to lower barriers that had previously excluded short-term or lower-intensity RTM patients from reimbursement. The surprise increase in practice-expense values on top of these structural improvements makes the 2026 RTM landscape more financially attractive than it has ever been.
2026 RTM Reimbursement: The Numbers at a Glance
The table below shows the shift across the key MSK RTM codes, comparing 2025 national payment amounts, the originally expected 2026 rates, and the actual 2026 reimbursement figures:
Refer to the CMS Physician Fee Schedule Lookup Tool for your Medicare Administrative Contractor's exact rates.
The bolded story here is 98977 and 98985 - the device supply codes that underpin the financial sustainability of any RTM program. These are the codes that cover device logistics, monitoring infrastructure, and patient engagement overhead. When these rates rise, the math on running a compliant RTM program at scale improves dramatically.
What This Means for Organizations Considering RTM
For most practices, RTM hesitation has been financial, not clinical. The patient benefits are clear. The 2026 update addresses the ROI concern directly.
Key reasons to act now:
- Higher reimbursement on device supply codes reduces operational risk
- New 2–15 day code opens RTM to short-term and lower-intensity patients
- Lower time thresholds mean more patients qualify for management billing
- Physical therapists and occupational therapists can now bill RTM directly
- Organizations with existing Remote Patient Monitoring programs can leverage the same workflows for RTM
One critical billing rule: RTM and RPM cannot be billed for the same patient in the same calendar month. Only the first submitted claim will be paid. Choose the right program based on whether the patient's monitoring is physiological (RPM) or therapeutic/adherence-based (RTM).
RTM and the Broader Remote Care Picture
It is worth situating this RTM update within the larger pattern CMS has established across remote care programs in 2026. Across CCM, RPM, RTM, APCM, PCM, and CGM, every comparable code from 2025 moved higher in 2026. CMS is not retreating from digital and remote care - it is expanding the framework.
RTM works best as part of an integrated portfolio alongside:
- Chronic Care Management (CCM): For patients with 2+ chronic conditions
- Remote Patient Monitoring (RPM): For continuous physiological data tracking
- Behavioral Health Integration (BHI): For whole-patient care
- Principal Care Management (PCM): For single high-risk chronic conditions
- Transitional Care Management (TCM): For post-discharge support
One important billing note: RTM and RPM cannot be billed for the same patient in the same calendar month. The first submitted claim will be reimbursed; the second will be denied. Selecting the right program for each patient - based on whether their monitoring needs are physiological (RPM) or therapeutic and adherence-based (RTM) - is essential for both compliance and maximum reimbursement capture.
How Circle Health Supports RTM Implementation
Circle Health's AI-powered care management platform is built to support the full lifecycle of RTM and RPM programs - from patient identification and enrollment through daily monitoring, clinical escalation, and CMS-compliant billing documentation.
For organizations ready to move from interest to implementation, our team of licensed RNs and clinical care managers works as an extension of your practice, handling the monitoring workload without adding to your staff overhead. There is no upfront infrastructure investment, and most programs are operational within 30 days.
With the 2026 reimbursement increase now confirmed, the financial case for RTM is clearer than it has been since the program's introduction in 2022. The question for most organizations is no longer whether RTM is worth pursuing - it is how quickly they can build a program designed to capture the full opportunity.
Conclusion
CMS's unexpected increase in 2026 RTM reimbursement rates marks a significant turning point for healthcare organizations considering remote therapeutic monitoring. Combined with new CPT codes, expanded billing opportunities, and continued support for digital care initiatives, the updated reimbursement framework makes RTM more financially viable and operationally accessible than ever before. For practices looking to improve patient adherence, expand value-based care programs, and create sustainable recurring revenue streams, now is the ideal time to evaluate and implement an RTM strategy. Organizations that act early and build compliant, scalable programs will be best positioned to capitalize on the growing opportunities in remote care and deliver better outcomes for their patients.
Frequently Asked Questions
What are CPT codes 98977 and 98985?
These are the device supply codes within the MSK RTM family. CPT 98977 covers 16–30 days of monitoring data transmission, while CPT 98985 is a new 2026 code that covers the 2–15 day monitoring window, enabling reimbursement for shorter-duration monitoring episodes.
Can physical therapists bill RTM in 2026?
Yes. Unlike RPM, RTM allows physical therapists and occupational therapists to bill for services, in addition to physicians and other qualified healthcare professionals. Services provided by therapists must be delivered under a therapy plan of care with the appropriate modifier.
Can I bill RTM and RPM for the same patient?
No. RTM and RPM cannot be billed concurrently for the same patient during the same calendar month. Only the first submitted claim will be reimbursed.
Where can I find the exact reimbursement rates for my region?
The CMS Physician Fee Schedule Lookup Tool provides reimbursement rates by Medicare Administrative Contractor. National averages may vary based on your specific locality.
How does Circle Health help with RTM billing compliance?
Circle Health's platform automates documentation for each RTM billing code by tracking data transmission days, clinical staff time, and patient interaction requirements, while performing pre-submission checks to identify potential compliance gaps before claims are submitted.